Depression and anxiety in patients receiving interferon-alpha: The role of illness perceptions.

Development of psychiatric symptoms during interferon-alpha therapy may be influenced by psychological factors. We examined illness perceptions using the Revised Illness Perceptions Questionnaire in 55 patients with chronic hepatitis C virus infection, due to receive interferon-alpha. The Hospital Anxiety and Depression Scale was used to assess the development of symptoms.

Psychiatric aspects of acute withdrawal from gamma-hydroxybutyrate (GHB) and its analogue gamma-butyrolactone (GBL): implications for psychiatry services in the general hospital.

Objective: The objective of this study was to describe the psychiatric symptoms, management and outcomes in a consecutive series of patients being managed medically for symptoms of withdrawal from gamma-hydroxybutyrate (GHB) and its analogue gamma-butyrolactone (GBL) in a general hospital setting.

Methods: A toxicology database was used to identify patients presenting with a history suggestive of withdrawal from GHB and analogues. Electronic and paper medical records were searched for demographic features, neuropsychiatric symptoms, psychiatric management while in hospital and overall outcome.

Understanding clinical risk decision making regarding development of depression during interferon-alpha treatment for hepatitis-C: a qualitative interview study.

Background: Hepatitis C virus (HCV) affects 170 million worldwide. Currently, around 30% of patients receiving interferon-alpha (IFN-α) treatment for HCV experience clinically significant depression. Effective and timely detection of depression is crucial to ensuring appropriate treatment and support.

Quality of psychiatric care in the general hospital: referrer perceptions of an inpatient liaison psychiatry service.

Aims: To explore the experience of senior staff on acute medical wards using an established inpatient liaison psychiatry service and obtain their views on clinically relevant performance measures.

Methods: Semistructured face-to-face interviews with consultants and senior nurses were taped, transcribed and analyzed manually using the framework method of analysis.

Results: Twenty-five referrers were interviewed.

Malayalam cinema and mental health.

There is a tradition of using films to teach various aspects of psychiatry and we feel that Malayalam cinema can also be used suitably to teach effectively. These films can be an invaluable resource in cultural competency training as they depict the effects of culture on psychopathology and cultural and regional influences on attitudes to mental illness and stigma. We also note that the portrayal is often far from reality but this is not a barrier for using the films as an effective alternative to traditional and didactic teaching methods.

Delirium and its treatment.

Delirium occurs at rates ranging from 10% to 30% of all hospital admissions. It is a negative prognostic indicator, often leading to longer hospital stays and higher mortality. The aetiology of delirium is multifactorial and many causes have been suggested.

Depression, demoralisation or adjustment disorder? Understanding emotional distress in the severely medically ill.

As emotional distress is often seen as an understandable reaction to a severe or life-threatening illness, clinicians are reluctant to make a diagnosis of depression and resort to alternative diagnoses such as adjustment disorder (AD) or demoralisation. This paper introduces these concepts and critically examines their clinical utility. It concludes that neither AD nor demoralisation can be clearly distinguished from depression on variables such as clinical symptoms, outcome or treatment response.

Dhat syndrome as a functional somatic syndrome: developing a sociosomatic model.

Dhat syndrome is a widely recognized condition from the Indian subcontinent with fatigue and preoccupation with semen loss as the main presenting symptoms. This condition has been considered to be a culture-bound syndrome, but little is known about its illness characteristics and similarities with other conditions with medically unexplained symptoms. In this paper we review the current research on dhat syndrome, discuss its similarities and differences with other functional somatic syndromes, and propose an integrated model that incorporates both psychological and sociocultural factors.

Dhat (semen loss) syndrome: a functional somatic syndrome of the Indian subcontinent?

Objective: To study the illness characteristics of Dhat syndrome, which has been widely regarded as a culture-bound syndrome.

Methods: The sample was selected from a general hospital and included 29 patients with Dhat syndrome and 32 medical controls. Somatization Screening Index (SSI), Illness Behaviour Questionnaire (SIBQ), Somatosensory Amplification Scale (SAS), Whitley Index (WI) and Chalder Fatigue Scale were administered to both groups.

Personality as a determinant of social functioning in depression.

Background: The Social Adaptation Self-Evaluation Scale (SASS) is an instrument for measuring drive-based aspects of social functioning and has been used in trials of antidepressants. It has been suggested that social adaptation may be akin to a personality trait. We investigated the personality dimensions of neuroticism and extraversion as determinants of social functioning measured by SASS in patients with depression.

'Refusing treatment--please see': an analysis of capacity assessments carried out by a liaison psychiatry service.

The assessment of capacity to consent to a healthcare decision is an important part of day-to-day work in general hospitals. The role of liaison psychiatric services in assessment of capacity has not been well studied in British practice. We looked at all such referrals (35) to a liaison psychiatric service in a teaching hospital in the course of one year.